• Experience in the implementation of adenotomy in children

Experience in the implementation of adenotomy in children

SOVREMENNAYA PEDIATRIYA.2018.8(96):37-41; doi 10.15574/SP.2018.96.37

Kosakivska I. A.
Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine

Introduction. Adenotomy is the most common surgical intervention in children. The most common complications of adenotomy are bleeding and recurrence of the disease.

The aim of the study was to increase the effectiveness of adenotomy in children.

Material and methods. Under our supervision in the clinic, there were 183 children with adenoidal vegetations aged 2 to 15 years. The girls were 85, boys — 98. The adenoidal vegetations of the II degree took place at 27.3%, the ІІІ degree — 72.7%. In 2.7% of the lymphoid tissue from the nasopharynx spread through the hoans into the nasal cavity. In the main group there were 146 children, in the control group — 37. To remove adenoid vegetations, bipolar adenomas were used, and hemostasis in the postoperative wound was performed using bipolar electrodes of its own design.

Results and discussion. Surgical treatment was performed in 183 children with adenoid vesicles. In adenotomy, according to the traditional method (control group), intraoperative blood loss was 26.24±1.737 ml, while using high-frequency current (main group) — 3.36±0.233 ml (p<0.001). The proposed technique of surgical treatment of chronic diseases of the lymphocyte ring in children allowed us to restore physiological respiration in all cases. The use of electrothermagazies of the adenoid vegetation residues allowed to restore the lumen of the chicken, to avoid recurrence of the disease and to preserve a small part of the pharyngeal tonsil, which is important for the restoration of its function.

Conclusions. The technique of adenotomy in children using the electric welding technology of living biological tissues can restore physiological respiration, significantly reduce intraoperative blood loss, prevent post-operative bleeding, restore or improve hearing, and avoid recurrence of the disease in all cases, which indicates its high effectiveness.

Key words: children, adenoid vegetations, treatment.

REFERENCES

1. Bezshapochnyiy SB, Gasyuk YuA, Smeyanov EV. (2017). Giperplaziya i vospalenie glotochnoy mindalinyi. Kiyiv: Logos: 123.

2. Zlobina NV, Asmanov AI, Radtsig EYu. (2016). Sovremennyie metodyi hirurgicheskogo lecheniya struktur nosoglotki: preimuschestva i perspektivyi. Lechebnoe delo. 2: 58–63.

3. Kosakivska I.A. (2012). Patent Ukrainy na vynakhid No. 99043. MPK (2012.01) A61V17/00. Bipoliarnyi elektroprystrii dlia koahuliatsii tkanyn. Zaiavleno 01.03.2011; Opubl. 10.07.2012 r. Biul. No.13.

4. Kosakivska I.A. (2017) Patent Ukrainy na korysnu model No. 113320. MPK (2006.01) A61V17/24, A61V17/26. Bipoliarnyi elektroprystrii dlia koahuliatsii. Zaiavleno 02.07.2016; Opubl. 25.01.2017 r. Biul. No.2.

5. Kosakivska I.A. (2017). Patent Ukrainy na korysnu model No. 114693. MPK (2006.01) A61V18/04, A61V18/14. Prystrii dlia koahuliatsii. Zaiavleno 26.10.2016; Opubl. 10.03.2017 r. Biul. No.5.

6. Kosakivska I.A., Diachuk V.V., Kosakovskyi A.L., Diachuk V.V. (2011). Patent Ukrainy na korysnu model No. 60107. MPK (2006.01) A61V17/24. Prystrii dlia fiksatsii miakoho pidnebinnia. Zaiavleno 22.11.2010; Opubl. 10.06.2011 r. Biul. No.11.

7. Kosakovskyi A.L., Kosakivska I.A. (2003). Deklaratsiinyi patent Ukrainy na vynakhid No. 54273 A. MPK7 A61V17/00, A61V1/24. Rotorozshyriuvach. Zaiavleno 09.07.2002; Opubl. 17.02.2003 r. Biul. No. 2.

8. Kosakovskyi A.L., Kosakivska I.A., Semenov R.H. (2010). Patent Ukrainy na vynakhid No. 91640. MPK (2009) A61V17/32, A61V17/3205 (2006.01), A61V18/12. Adenotom A.L. Kosakovskoho. Zaiavleno 20.03.2009; Opubl. 10.08.2010 r. Biul. No.15.

9. Kosakovskyi A.L., Kosakivska I.A., Semenov R.H., Semenov V.R. (2011). Patent Ukrainy na vynakhid No. 96641. MPK A61V17/24 (2006.01), A61V17/32 (2006.01), A61V17/3211 (2006.01). Adenotom Kosakovskoho–Semenova. Zaiavleno 13.01.2010; Opubl. 25.11.2011 r. Biul. No.22.

10. Kosakovskyi A.L., Kosakivska I.A., Shukh L.A. (2003). Deklaratsiinyi patent Ukrainy na vynakhid No. 60877 A. MPK7 A61V1/24, A61V17/00. Rotorozshyriuvach. Zaiavleno 24.03.2003; Opubl. 15.10.2003 r. Biul. No. 10.

11. Laiko AA, Zabolotnyi DI, Kosakovskyi AL ta in. (2006). Adenoidni vehetatsii ta adenoidyty. Kyiv: Lohos: 171.

12. Laiko AA, Zabolotnyi DI, Melnykov OF ta in. (2010). Adenoidyt. Kyiv: Lohos: 178.

13. Laiko AA, Kosakovskyi AL, Zabolotna DD ta in. (2013). Dytiacha otorynolarynholohiia. Natsionalnyi pidruchnyk. Za red. Laika AA. Kyiv: Lohos: 576.

14. Puhlik SM, Neyvirt EG. (2002). Adenotomiya: istoricheskiy aspekt. Rinologiya. 2: 70–71.

15. Puhlik SM. (2016). Adenotomiya — istoricheskiy ekskurs. Zdorov'ya Ukrayini. 1: 37–39.

Article received: Jul 24, 2018. Accepted for publication: Nov 27, 2018.